Provider Demographics
NPI:1225037203
Name:CHAUDHRY, NASAR A (PLLC)
Entity Type:Individual
Prefix:DR
First Name:NASAR
Middle Name:A
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 SENECA RD
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1033
Mailing Address - Country:US
Mailing Address - Phone:607-324-5031
Mailing Address - Fax:607-324-0585
Practice Address - Street 1:327 SENECA RD
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1033
Practice Address - Country:US
Practice Address - Phone:607-324-5031
Practice Address - Fax:607-324-0585
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116917207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00025194503OtherUNIVERA PIN
NYP00000200998OtherGHI-FHP PIN
NY000506265005OtherBCBS WESTERN PIN
NYP010116917OtherBLUE CHOICE PIN
NY100664OtherPREFERRED CARE PIN
116917OtherLICENSE NUMBER
NY00459114Medicaid
NY2589781OtherGHI PIN
NY000006369OtherBCBS CENTRAL PIN
NYRA8038Medicare PIN
NY000006369OtherBCBS CENTRAL PIN
B81823Medicare UPIN
NY2589781OtherGHI PIN